BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ADVANCE® ONLAY ALL-POLY PATELLA 32MM TRI-PEG

    MDR report key: 15712003 · Received November 1, 2022

    Report

    Report Number
    3010536692-2022-00381
    Event Type
    Injury
    Date Received
    November 1, 2022
    Date of Event
    September 25, 2022
    Report Date
    December 14, 2022
    Manufacturer
    MICROPORT ORTHOPEDICS INC.
    Product Code
    JWH
    UDI-DI
    M684KPONTP321
    PMA / PMN Number
    K953439
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    ID, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    THIS EVENT WILL BE UPDATED ONCE THE INVESTIGATION IS COMPLETE. TRENDS WILL BE EVALUATED.

    Additional Manufacturer Narrative · 0

    AFTER FURTHER ANALYSIS OF THIS EVENT FROM RELIABILITY ENGINEERING, IT HAS BEEN DETERMINED THAT THIS DEVICE SHOULD BE CONSIDERED AS NO COMPLAINT STATED SINCE THERE'S NOT AN ALLEGED DEFICIENCY AGAINST THE DEVICE. IT IS IDENTIFIED THAT THE COMPLAINT IS AGAINST THE NITRIX COMPONENTS. PLEASE VOID THIS REPORT.

    Description of Event or Problem · 0

    ALLEGEDLY, REPORTER BECAME AWARE OF SOME NITRX COMPLAINTS FROM A SURGEON IN (B)(6) HOWEVER, NO INFORMATION ABOUT THE COMPLAINTS WERE GIVEN TO REPORTER. MICROPORT ORTHOPEDICS VP R&D PROD. DEVELOPMENT STATED THAT HE RECEIVED A PHONE CALL FROM (B)(4) (SALES REP) SAYING THAT A DOC IN (B)(6) HAD A FEW PATIENTS COME BACK IN WITH PAINFUL, SWOLLEN KNEES. HE CONTACTED THE REP TO SEE IF HE COULD GET MORE DETAILS. HE ASKED A SERIES OF QUESTIONS THAT HE DID NOT KNOW THE ANSWER. NO PART/LOT NUMBERS ARE GIVEN AND IT HAS NOT BEEN INDICATED HOW MANY EVENTS/PATIENTS HAVE OCCURRED REGARDING THESE ISSUES. ADDITIONAL INFORMATION RECEIVED ON 10/05/2022: A TOTAL OF 8 COMPLAINTS WERE RECEIVED WITH ALL RELEVANT INFORMATION INCLUDED IN EACH INCIDENT FORM. THE 7 REMAINING COMPLAINTS ARE CAPTURED UNDER DIFFERENT MICROPORT INCIDENT GROUP NUMBERS. ALLEGEDLY, RECURRING KNEE EFFUSION. NO INFECTION TO DATE. IT WAS CONFIRMED THAT EACH OF THESE PATIENTS WERE SEEN FOR FOLLOW-UP APPOINTMENTS TO ADDRESS INFLAMMATION IN THEIR KNEES. THE SURGEON CONFIRMED THAT NONE OF THE PATIENTS HAD INFECTIONS AND THAT THEIR KNEES HAD FLUID BUILDUP THAT WAS DRAINED. THE SURGEON HAS NOT BEEN ABLE TO DETERMINE IF THESE EVENTS WERE CAUSED BY AN ALLEGED DEFICIENCY/FAILURE AGAINST THESE DEVICES OR IF THEY WERE CAUSED DUE TO PATIENT CONDITIONS. IT IS INDICATED THAT THERE IS NO ACCESS TO INFORMATION REGARDING EACH PATIENT'S CONDITION, ACTIVITY LEVEL, MEDICAL HISTORY, ETC. INCIDENT FORM RECEIVED CONTAINS TWO EVOLUTION® MP CS INSERTS AND TWO ADVANCE® ONLAY ALL-POLY PATELLA HOWEVER ONLY ONE INSERT (EIS6S10R) AND ONLY ONE PATELLA (LOT: 1848258) ARE INDICATED AS A REVISED COMPONENTS. COMPONENTS NOT REVISED: PRODUCT ID: EFSAN6PR, EVOLUTION® NITRX? FEM CS/CR NONPOR TINBN COATED SIZE 6 PRIMARY RIGHT, LOT: 1853764, QTY: 1. PRODUCT ID: ETAKN6SR, EVOLUTION® NITRX? TIB KEELED NONPOR TINBN COATED SIZE 6 PRIMARY RIGHT, LOT: 17793341854578, QTY: 1. PRODUCT ID: K0001288, ADVANCE® EVOLUTION® PIN PACK 3 LONG & 2 COLLARED STERILE, LOT: 1858766, QTY: 1. PRODUCT ID: EIS6S12R, EVOLUTION® MP? CS INSERT SIZE 6 STANDARD 12MM RIGHT, LOT: 1889755. PRODUCT ID: KPONTP32, ADVANCE® ONLAY ALL-POLY PATELLA 32MM TRI-PEG, LOT: 1885943, QTY: 1.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2798605 ADVANCE® ONLAY ALL-POLY PATELLA 32MM TRI-PEG KNEE COMPONENT JWH MICROPORT ORTHOPEDICS INC. KPONTP32 1848258 M684KPONTP321

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Male Required Intervention